睾丸与附睾精子对梗阻性无精子症ICSI助孕结局的影响  

The effects of testicular sperm and epididymal sperm on the outcomes of ICSI for patients with obstructive azoospermia

作　　者：孙文枫[1] 黄元华[1] 谢宝国[1] 张毅[1] 卢伟英[1] 

机构地区：[1]海南医学院第一附属医院生殖医学中心,海口570102

出　　处：《中国优生与遗传杂志》2017年第7期114-116,113,共4页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金(81560244);海南省科技厅重大项目课题(ZDXM2015075)

摘　　要：目的比较睾丸精子与附睾精子对梗阻性无精子症(obstructive azoospermia,OA)患者行卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗结局的影响。方法收集2014年1月至2016年12月在海南医学院第一附属医院生殖医学中心因梗阻性无精子症行ICSI助孕治疗患者的临床资料,共163个周期。根据精子来源分为两组,TESA组:采用睾丸精子抽吸术(testicular sperm aspiration,TESA)取精,共137个周期;PESA组:采用经皮附睾精子抽吸术(percutaneous epididymal sperm aspiration,PESA)取精,共26个周期。比较两组的正常受精率、2PN卵裂率、优质胚胎率、胚胎利用率、胚胎种植率、临床妊娠率、流产率及活产率之间有无差异。结果 TESA组的胚胎种植率、临床妊娠率及活产率高于PESA组,但差异均无统计学意义(P>0.05);TESA组的正常受精率、2PN卵裂率、优质胚胎率、胚胎利用率及流产率均低于PESA组,但差异亦无统计学意义(P>0.05)。结论对梗阻性无精子症患者,睾丸精子和附睾精子ICSI后可达到相似的助孕结局。Objective： To compare the effects of testicular sperm and epididymal sperm on the outcomes of intracytoplasmic sperm injection （ICSI） for patients with obstructive azoospermia （OA） . Methods： The data was collected from 163 ICSI cycles for patients with OA from Jan. 2014 to Dec. 2016 in the First Affiliated Hospital of Hainan Medical College. It was divided into 2 according to the source of sperm, TESA group： testicular sperm aspiration group （n=137） ; PESA group： percutaneous epididymal sperm aspiration group （n=26） . We assessed the differences of normal fertilization rate, cleavage rate of 2PN, high- quality embryo rate, embryo Utilization rate, implantation rate, clinical pregnancy rate, abortion rate and live birth rate in the two groups. Results： The implantation rate, clinical pregnancy rate and live birth rate of TESA group was higher than that of PESA group, but there was no statistically significant difference （P〉0.05） ; The normal fertilization rate, cleavage rate of 2PN, high-quality embryo rate, embryo utilization rate and abortion rate was lower than that of PESA group, but the difference was still not statistically significant （P〉0.05） . Conclusion： ICSI with testicular sperm and epididymal sperm can achieve similar clinical outcomes in the patients with obstructive azoospermia.

关 键 词：梗阻性无精子症 卵胞浆内单精子注射 睾丸精子 附睾精子 

分 类 号：R698.2[医药卫生—泌尿科学]